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Medina A, Nilles C, Martino D, Pelletier C, Pringsheim T. The prevalence of idiopathic or inherited isolated dystonia: a systematic review and meta‐analysis. Mov Disord Clin Pract 2022; 9:860-868. [PMID: 36247920 PMCID: PMC9547134 DOI: 10.1002/mdc3.13524] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022] Open
Abstract
Background A systematic review of epidemiological studies of primary dystonia from 1985 and 2010 found an overall prevalence of 16.43 per 100,000 (95% CI = 12.09–22.32). Methods We performed a systematic review of studies from 2010 and 2022 to determine if there are important differences in epidemiology between these time periods. Results Nineteen studies were included. Incidence of cervical dystonia, blepharospasm, and oromandibular dystonia were each reported in one study; one study reported incidence for all adult onset idiopathic focal dystonias combined. Using data from 11 studies, we performed random effects meta‐analyses of the prevalence of cervical dystonia (9.95 per 100,000; 95% CI = 3.51–28.17), blepharospasm (2.82 per 100,000; 95% CI = 1.12–7.12), laryngeal dystonia (0.40 per 100,000; 95% CI = 0.09–1.83), upper limb dystonia (1.27 per 100,000; 95% CI = 0.36–4.52), oromandibular dystonia (0.57 per 100,000; 95% CI = 0.15–2.15), and idiopathic or inherited isolated dystonia all subtypes combined (30.85 per 100,000; 95% CI = 5.06–187.74). All studies reported more cases of dystonia in females. There was no significant difference in prevalence by subgroup analysis based on time of study publication (1985–2010 vs. 2010–2022). Subgroup analysis of differences in prevalence by dystonia subtype by continent using all studies published (1985–2022) revealed significant regional differences in the prevalence of cervical and laryngeal dystonia. Conclusion The incidence and prevalence of idiopathic or inherited isolated dystonia in the last decade was not significantly different from earlier reports. Population‐based studies across multiple geographic areas are needed to obtain a clearer understanding of the epidemiology of this condition.
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Affiliation(s)
- Alex Medina
- Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada
| | - Christelle Nilles
- Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
| | | | - Tamara Pringsheim
- Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
- Department of Psychiatry, Pediatrics, Community Health Sciences University of Calgary Calgary Alberta Canada
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Epidemiology of Cerebral Palsy among Children and Adolescents in Arabic-Speaking Countries: A Systematic Review and Meta-Analysis. Brain Sci 2022; 12:brainsci12070859. [PMID: 35884667 PMCID: PMC9313288 DOI: 10.3390/brainsci12070859] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Studies on cerebral palsy among children and adolescents in Arabic-speaking countries are scarce. In this systematic review, we aimed to describe the epidemiology of cerebral palsy among children and adolescents in Arabic-speaking countries in terms of prevalence, risk factors, motor types, and rehabilitation. Methods: Six key bibliographic databases were searched for relevant literature published to 17 July 2021. Titles and abstracts were screened for potential inclusion and two independent reviewers screened the full texts of potential articles following pre-defined inclusion/exclusion criteria. The included studies were evaluated independently by three reviewers. The risk of bias was assessed, and data were extracted and analysed. Results: A total of 32 studies from 7 countries met our inclusion criteria. The prevalence of cerebral palsy in Arabic-speaking countries was 1.8/1000 live births (95% CI: 1.2–2.5). Spastic cerebral palsy was the most common motor type, representing 59.8% (95% CI: 46.2–72.7) of pooled estimates. This included children with spastic quadriplegia, diplegia, and hemiplegia; 25.1% (95% CI: 18.2–32.8), 16.2% (95% CI: 11.4–23.3), and 10.4% (95% CI: 7.3–13.8), respectively. Consanguinity was high and represented 37.7% (95% CI: 29.3–46.6). Only one included study reported the types of rehabilitation received (e.g., physiotherapy and assistance devices). Conclusions: This paper provides a summary of the epidemiology of cerebral palsy in Arabic-speaking countries and highlights areas for future research. There is still a substantial knowledge gap on the epidemiology of cerebral palsy in these regions. Countries in the Arab region should follow examples of countries that have successfully established cerebral palsy registries to generate evidence on epidemiology of cerebral palsy and opportunities for prevention.
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Prapiadou S, Demel SL, Hyacinth HI. Genetic and Genomic Epidemiology of Stroke in People of African Ancestry. Genes (Basel) 2021; 12:1825. [PMID: 34828431 PMCID: PMC8619587 DOI: 10.3390/genes12111825] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Stroke is one of the leading causes of disability and death worldwide and places a significant burden on healthcare systems. There are significant racial/ethnic differences in the incidence, subtype, and prognosis of stroke, between people of European and African ancestry, of which only about 50% can be explained by traditional stroke risk facts. However, only a small number of genetic studies include individuals of African descent, leaving many gaps in our understanding of stroke genetics among this population. This review article highlights the need for and significance of including African-ancestry individuals in stroke genetic studies and points to the efforts that have been made towards this direction. Additionally, we discuss the caveats, opportunities, and next steps in African stroke genetics-a field still in its infancy but with great potential for expanding our understanding of stroke biology and for developing new therapeutic strategies.
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Affiliation(s)
- Savvina Prapiadou
- Department of Medicine, University of Patras School of Medicine, 26223 Patras, Greece;
| | - Stacie L. Demel
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45221, USA;
| | - Hyacinth I. Hyacinth
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45221, USA;
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Utilization of Multiple Sclerosis Therapies in the Middle East Over a Decade: 2009-2018. CNS Drugs 2021; 35:1097-1106. [PMID: 34164782 DOI: 10.1007/s40263-021-00833-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The multiple sclerosis (MS) landscape has changed over the past two decades across the world and in the Middle East. The Middle East is an ethnically diverse region located between 12° and 42° of latitude and 35° and 54° of longitude and varying altitudes. The magnitude of the shifts observed in the epidemiology and management of MS differ in each region and from country to country. OBJECTIVES The aim of this study was to provide a clinicodemographic overview of the cohorts of patients contributed to MSBase, a large international MS registry, in the Middle East and describe disease-modifying treatment (DMT) utilization in the different countries within the region. Understanding the differences between these cohorts is integral to interpretation of the studies conducted using registry data and provides insight into clinical practice in these cohorts. METHODS The MSBase registry was searched for patients with MS or clinically isolated syndrome from the Middle Eastern countries with data captured between 2009 and 2018. In 2-year epochs, and with special focus on the most recent epoch (2017-2018), we explored the demographic, clinical characteristics and treatment exposures of the studied cohorts and reported the results using standard descriptive statistics. RESULTS Over the 10-year study period, 13,356 patients from 17 centers in 8 Middle Eastern countries fulfilled the inclusion criteria. The represented countries were Egypt, Iran, Kuwait, Lebanon, Oman, Saudi Arabia, Turkey and the United Arab Emirates. Overall, the represented cohort was young (median 36 years, quartiles 29-45) and captured relatively early after the onset of MS (median disease duration < 10 years, quartiles 3-12). The relapsing-remitting phenotype was the most prevalent phenotype in all countries (73-97%) and the highest proportion of progressive MS was reported in Saudi Arabia (12%). Median Expanded Disability Status Scale (EDSS) ranged from 0 to 3, depicting a mildly disabled cohort, with the exception of Saudi Arabia where the median EDSS was 4 (quartiles 1.5-6.5). The median relapse frequency was highest in Lebanon (median 1.03, 95% CI 0.94-1.16) followed by Egypt (median 1.02, 95% CI 0.89-1.24) and lowest in Saudi Arabia (median 0.70, 95% CI 0.58-0.95) and Kuwait (median 0.75, 95% CI 0.71-0.80). The treatment landscape greatly varied between different countries. Platform injectable therapies were mostly utilized in Egypt, Iran and Turkey (86%, 79% and 53%, respectively), while oral therapies and monoclonal antibodies were more commonly used in Kuwait, Lebanon and the United Arab Emirates (87.2%, 67.3% and 58.7%, respectively). CONCLUSION Patients in the Middle East enrolled in a large multinational registry are representative of the general MS population. The spectrum of therapies used in the individual countries, however, is highly variable. Further studies that include rural and non-academic practices are needed to enhance our understanding of the MS cohorts in the Middle East.
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5
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Alluqmani M, Roda W, Qqrmli M, Blevins G, Giuliani F, Power C. Differential disease phenotypes and progression in relapsing-remitting multiple sclerosis: comparative analyses of single Canadian and Saudi Arabian clinics. BMC Neurol 2021; 21:295. [PMID: 34311734 PMCID: PMC8314572 DOI: 10.1186/s12883-021-02317-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/02/2021] [Indexed: 12/04/2022] Open
Abstract
Objective Relapsing–remitting multiple sclerosis (RR-MS) phenotypes differ widely although the variables contributing to this heterogeneity remain uncertain. To assess geographic and ethnic effects on RR-MS phenotypes, we investigated RR-MS patients in Canada and Saudi Arabia. Methods A retrospective analysis of patients followed in two MS Clinics was performed in Medina, Saudi Arabia and Edmonton, Canada. Demographic and clinical data were collected for each patient and analyzed using univariable and multivariable statistics. Univariable and multivariable linear regression were used to distinguish the significant clinical and demographic features and neurological systems associated with the change in expanded disability status scale (EDSS) between clinical assessments. Results Patients with treated RR-MS were recruited (n = 51, Saudi; n = 47, Canada) although the disease duration was longer in the Canadian cohort (5.6 ± 2.2 yr.) compared to the Saudi cohort (4.4 ± 1.4 yr.) (P < 0.05), annual relapse rate and EDSS change were higher in the Saudi cohort (P < 0.05). Infratentorial lesion-associated presentation differed (Canada, n = 23; Saudi, n = 13) among groups (P < 0.05). Spinal cord lesions on MRI were more frequently detected in Canadian (n = 23) compared to Saudi (n = 1) patients (P < 0.05). Patients within the Saudi cohort displayed a significantly greater change in Expanded Disability Status Scale (EDSS) between first and second assessments. Conclusions Despite differences in geographic location, ethnicity, and predominance of infratentorial lesions in the Canadian group, the RR-MS phenotypes were similar although the Saudi cohort displayed a more severe disease course. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02317-2.
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Affiliation(s)
- M Alluqmani
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada.,Department of Medicine, University of Taibah, Medina, Saudi Arabia
| | - W Roda
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
| | - M Qqrmli
- Department of Medicine, University of Taibah, Medina, Saudi Arabia
| | - G Blevins
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada
| | - F Giuliani
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada
| | - C Power
- Department of Medicine (Neurology), University of Alberta, 6-11 Heritage Medical Research Centre, Edmonton, AB, Canada.
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Farghaly WM, El Tallawy HN, Mohamed H, El Tallawy SH, Abdelhamed MA. Construction and Standardization of Dementia Arabic Scale. Neuropsychiatr Dis Treat 2021; 17:721-729. [PMID: 33716503 PMCID: PMC7947332 DOI: 10.2147/ndt.s291392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/30/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Validated diagnostic scales for dementia in Arabic are still scarce. The aim of this study is to construct a standardized dementia scale for dementia diagnosis among the Arabic-speaking population. PATIENTS AND METHODS Construction of the Dementia Arabic Scale (DAS) was done, followed by evaluation of content validity. A pilot study was done to ascertain feasibility and language clarity used in the scale. Patients diagnosed to have major neurocognitive disorder according to DSM-V criteria and control group were subjected to DAS, mini-mental state examination (MMSE) and Cognitive Abilities Screening Instrument (CASI). Finally, standardization of the scale and estimation of cutoff point, sensitivity, specificity, positive predictive value and negative predictive value of the newly constructed scale (DAS) were done. RESULTS There is significant correlation between DAS and both MMSE and CASI on Pearson's correlation study. The internal consistency of the DAS scale was good, with Cronbach's alpha correlation coefficient of 0.88. At cut-off ≤95 for literate, and ≤68 for illiterate, the sensitivity of the DAS scale was 100%, 87% for literate and illiterate, respectively, while specificity was 84%, 96% respectively, with an area under the receiver operating characteristic curve of (AUC) 0.96. CONCLUSION The DAS scale is an acceptable, reliable and valid scale for the diagnosis of dementia in Arabic-speaking countries.
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Affiliation(s)
- Wafaa M Farghaly
- Department of Neuropsychiatry, and Neuroepidemiology Lab, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hamdy N El Tallawy
- Department of Neuropsychiatry, and Neuroepidemiology Lab, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Heba Mohamed
- Department of Neuropsychiatry, and Neuroepidemiology Lab, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Sara H El Tallawy
- Department of Psychology, Faculty of Arts, Assiut University, Assiut, Egypt
| | - Mohamed A Abdelhamed
- Department of Neuropsychiatry, and Neuroepidemiology Lab, Faculty of Medicine, Assiut University, Assiut, Egypt
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Bang S, Kim YS, Lee S, Park U, Kim TK, Choi Y. Prevalence of common causes of neuropathic pain in Korea: population-based observational study. J Int Med Res 2020; 48:300060519888102. [PMID: 31775560 PMCID: PMC7516997 DOI: 10.1177/0300060519888102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 10/22/2019] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of complex regional pain syndrome (CRPS), post-herpetic neuralgia (PHN), trigeminal neuralgia (TN), and diabetic neuropathy (DN), common causes of neuropathic pain encountered in pain clinics. METHODS We investigated the period prevalence rate of CRPS, PHN, TN, and DN using data from a Korean national electronic database from 2009 to 2013. RESULTS The prevalence of CRPS decreased slightly throughout the study period, while the prevalence of PHN increased from 2009 to 2013. The prevalence of TN was reduced over the same period. The prevalence of DN increased from 2009 to 2012 but decreased in 2013. All four neuropathic diseases were more prevalent in individuals aged over 70 years. The prevalence of CRPS, PHN, and TN were more common in women than in men, but DN showed no gender difference. CONCLUSION While the prevalence of CRPS and TN has decreased in Korea, that of PHN and DN has increased. With the exception of DN, the neuropathic diseases were more prevalent in women. Further studies are necessary to investigate the risk factors and socioeconomic burden for each disease, and national efforts are essential to limit the development of these preventable neuropathic diseases.
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Affiliation(s)
- Seunguk Bang
- Daejeon St. Mary's Hospital, College
of Medicine, The Catholic University of Korea, Anesthesiology and Pain Medicine,
Daejeon, Republic of Korea
| | - Yee Suk Kim
- Catholic University of Korea Bucheon
Saint Mary's Hospital, Department of Anesthesiology and Pain Medicine, Bucheon,
Republic of Korea
| | - Soyeon Lee
- Catholic University of Korea Bucheon
Saint Mary's Hospital, Department of Anesthesiology and Pain Medicine, Bucheon,
Republic of Korea
| | - Uijin Park
- Catholic University of Korea Bucheon
Saint Mary's Hospital, Department of Anesthesiology and Pain Medicine, Bucheon,
Republic of Korea
| | - Tae-kwan Kim
- Catholic University of Korea Bucheon
Saint Mary's Hospital, Department of Anesthesiology and Pain Medicine, Bucheon,
Republic of Korea
| | - Yuna Choi
- Catholic University of Korea Bucheon
Saint Mary's Hospital, Department of Anesthesiology and Pain Medicine, Bucheon,
Republic of Korea
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Khalil H, Chahine LM, Siddiqui J, Salari M, El-Jaafary S, Aldaajani Z, Abu Al-Melh M, Mohammad TM, Abu Snineh M, Syed NA, Bhatt M, Habib MA, Habahbeh M, Tabbal SD, Jeon B, Bajwa JA. Parkinson's Disease in the Middle East, North Africa, and South Asia: Consensus from the International Parkinson and Movement Disorder Society Task Force for the Middle East. JOURNAL OF PARKINSON'S DISEASE 2020; 10:729-741. [PMID: 32176653 PMCID: PMC8203232 DOI: 10.3233/jpd-191751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/09/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Understanding the regional needs and available healthcare resources to treat Parkinson's disease (PD) is essential to plan appropriate future priorities. The International Parkinson and Movement Disorder Society (MDS) Task Force for the Middle East was established to raise awareness and promote education across the region on PD and other movement disorders. Broadly, the task force encompasses the countries of the Middle East but has included North Africa and South Asia as well (MENASA). OBJECTIVE To create a list of needs and priorities in the advancement of PD in MENASA countries based on consensuses generated by the MDS task force for the Middle East. METHODS A Strengths Weaknesses-Opportunities-Threats (SWOT) analysis was conducted by the task force members to generate consensus about PD care this region. RESULTS Eight overarching principles emerged for the consensus statement on current needs: more movement disorders specialists, multidisciplinary care, accurate epidemiologic data, educational programs, availability of drugs, and availability of more advanced therapy, enhanced health care resources and infrastructure, and greater levels of awareness within the general population and among health care professionals. CONCLUSION This pilot study sheds light on unmet needs for providing care to people with PD in the MENASA region. These data offer directions on priorities to increase awareness of PD, to develop better infrastructure for research and management of PD, to foster healthcare policy discussions for PD and to provide educational opportunities within these countries.
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Affiliation(s)
- Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Lana M. Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Junaid Siddiqui
- Department of Neurology, University of Missouri, Columbia, MO, USA
| | - Mehri Salari
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zakiyah Aldaajani
- Neurology Unit, King Fahad Medical Military Complex, Dahran, Saudi Arabia
| | | | | | | | | | - Mohit Bhatt
- Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai, India
| | - Mohammad Ahsan Habib
- Department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Majed Habahbeh
- Department of Medicine, Neurology Section, King Hussein Medical Centre, Amman, Jordan
| | - Samer D. Tabbal
- Department of Neurology, Parkinson & Movement Disorders Program, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Beomseok Jeon
- Department of Neurology, Movement Disorders Center, Seoul National University, Seoul, South Korea
| | - Jawad A. Bajwa
- Department of Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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Nazish S, Shahid R, Zafar A, Alshamrani F, Sulaiman AA, Alabdali M, Aljaafari D, Al Wabari E, Alkhamis FA. Clinical Presentations and Phenotypic Spectrum of Multiple Sclerosis at a University Hospital in Saudi Arabia. J Clin Neurol 2018; 14:359-365. [PMID: 29971975 PMCID: PMC6031989 DOI: 10.3988/jcn.2018.14.3.359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/25/2018] [Accepted: 03/20/2018] [Indexed: 11/26/2022] Open
Abstract
Background and Purpose The objective of this study was to determine the frequencies of different clinical presentations and the phenotypic spectrum of multiple sclerosis (MS). Methods This cross-sectional study was performed in the Neurology Department of King Fahd Hospital of University Alkhobar in the Kingdom of Saudi Arabia (KSA). Data of 190 MS patients who fulfilled the McDonald criteria were retrieved from medical records and analyzed. Results The age at disease onset was 26.27±8.2 years (mean±SD) and disease duration was 6.38±5.10 years. The male-to-female ratio was 1:1.6. Optic neuritis and myelitis were the most-frequent first clinical presentations. Sensory (73.1%), motor (61%), and visual (58.4%) symptoms were the most-frequent established clinical symptoms. Relapsing-remitting multiple sclerosis (RRMS) was present in 75% of the cases. Supratentorial T2-weighted white-matter lesions and deep-gray-matter or juxtacortical lesions were the most-frequent magnetic resonance imaging (MRI) lesions, comprising 28% and 23.7% of all MRI lesions observed in 93.6% and 79.4% of the cases, respectively. The scores on the Expanded Disability Status Scale were within the range of 1.0–5.5 in 82.1% of the patients. There were 145 (76.3%) patients taking interferon β therapy. Conclusions MS presenting in the hospital setting is more common in KSA than reported previously, and the number of diagnosed cases in increasing. It is therefore an emerging and disabling neurological illness in KSA with clinical characteristics not dissimilar to those in other middle eastern countries. A decrease in the frequency of patients with secondary progressive multiple sclerosis (SPMS) indicates either that more new cases of RRMS are being diagnosed or that adequate treatments of RRMS are preventing the evolution to SPMS. Further larger and population-wide epidemiological and clinical studies with the long-term follow-up of MS patients are required to better assess the clinical spectrum of MS in KSA.
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Affiliation(s)
- Saima Nazish
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Rizwana Shahid
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Azra Zafar
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Foziah Alshamrani
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah Al Sulaiman
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Majed Alabdali
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Danah Aljaafari
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Esraa Al Wabari
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahd A Alkhamis
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Harden CL. The Plausibility of an Association Between Maternal Obesity and Onset of Childhood Epilepsy: A Well-Rounded, Robust Argument or a Thin Epidemiologic Association? Epilepsy Curr 2017; 17:288-290. [PMID: 29225542 PMCID: PMC5716498 DOI: 10.5698/1535-7597.17.5.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Elshahidi MH, Elhadidi MA, Sharaqi AA, Mostafa A, Elzhery MA. Prevalence of dementia in Egypt: a systematic review. Neuropsychiatr Dis Treat 2017; 13:715-720. [PMID: 28293113 PMCID: PMC5345900 DOI: 10.2147/ndt.s127605] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND With the growing prevalence of dementia worldwide, two-third of the people with dementia are projected to be from the developing countries by 2050. AIM This study reviews the literature regarding dementia prevalence in Egypt. METHODS Six databases were systematically searched from their dates of inception till July 2016. Studies published in English and reporting dementia prevalence among nonhospitalized individuals after clinical examinations were considered eligible. References were screened independently by two reviewers in two steps: 1) abstract screening and 2) full-text reviewing. In addition, quality of the included studies was assessed using the Newcastle-Ottawa scale. RESULTS Of the 1,630 references retrieved, six studies (n=28,029 participants) met our inclusion criteria. In all studies, dementia was ascertained using a three-phase survey (Phase I: screening, Phase II: clinical diagnosis, Phase III: laboratory investigations). The dementia prevalence ranged from 2.01% to 5.07%. Dementia increased with age, with the rapid increase among those aging ≥80. Also, its prevalence was higher among illiterate groups than among educated groups. Included studies were of low risk of bias. CONCLUSION Dementia prevalence in Egypt demands including people with dementia in the health care system and promoting the awareness of dementia among the public. Also, more epidemiological studies in this field are needed.
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Abstract
Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.
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Affiliation(s)
- Yad Ram Yadav
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Yadav Nishtha
- Department of Radio Diagnosis and Imaging, All India Institute of Medical Science, New Delhi, India
| | - Pande Sonjjay
- Department of Radio Diagnosis and Imaging, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Parihar Vijay
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Ratre Shailendra
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - Khare Yatin
- Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India
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Khedr EM, Fawi G, Abbas MAA, Abo El-Fetoh N, Zaki AF, Gamea A, Al Attar G. Prevalence of neuromuscular disorders in Qena governorate/Egypt: population-based survey. Neurol Res 2016; 38:1056-1063. [DOI: 10.1080/01616412.2016.1243640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eman M. Khedr
- Faculty of Medicine, Department of Neuropsychiatry, Assiut University, Assiut, Egypt
| | - Gharib Fawi
- Faculty of Medicine, Department of Neuropsychiatry, Sohag University, Sohag, Egypt
| | | | - Noha Abo El-Fetoh
- Faculty of Medicine, Department of Neuropsychiatry, Assiut University, Assiut, Egypt
| | - Ahmed F. Zaki
- Faculty of Medicine, Department of Neuropsychiatry, South Valley University, Qena, Egypt
| | - Ayman Gamea
- Faculty of Medicine, Department of Neuropsychiatry, South Valley University, Qena, Egypt
| | - Ghada Al Attar
- Faculty of Medicine, Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
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Owolabi MO, Akarolo-Anthony S, Akinyemi R, Arnett D, Gebregziabher M, Jenkins C, Tiwari H, Arulogun O, Akpalu A, Sarfo FS, Obiako R, Owolabi L, Sagoe K, Melikam S, Adeoye AM, Lackland D, Ovbiagele B. The burden of stroke in Africa: a glance at the present and a glimpse into the future. Cardiovasc J Afr 2016; 26:S27-38. [PMID: 25962945 PMCID: PMC4557491 DOI: 10.5830/cvja-2015-038] [Citation(s) in RCA: 243] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective Information on the current burden of stroke in Africa is limited. The aim of this review was to comprehensively examine the current and projected burden of stroke in Africa. Methods We systematically reviewed the available literature (PubMed and AJOL) from January 1960 and June 2014 on stroke in Africa. Percentage change in age-adjusted stroke incidence, mortality and disability-adjusted life years (DALYs) for African countries between 1990 and 2010 were calculated from the Global Burden of Diseases (GBD) model-derived figures. Results Community-based studies revealed an age-standardised annual stroke incidence rate of up to 316 per 100 000 population, and age-standardised prevalence rates of up to 981 per 100 000. Model-based estimates showed significant mean increases in age-standardised stroke incidence. The peculiar factors responsible for the substantial disparities in incidence velocity, ischaemic stroke proportion, mean age and case fatality compared to high-income countries remain unknown. Conclusions While the available study data and evidence are limited, the burden of stroke in Africa appears to be increasing.
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Affiliation(s)
- Mayowa O Owolabi
- College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | | | | | | | | | | | | | - Oyedunni Arulogun
- College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | | | | | | | | | | | - Sylvia Melikam
- College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Abiodun M Adeoye
- College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
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El-Tallawy HN, Farghaly WMA, Badry R, Metwally NA, Shehata GA, Rageh TA, El Hamed MA, Kandil MR. Prevalence of multiple sclerosis in Al Quseir city, Red Sea Governorate, Egypt. Neuropsychiatr Dis Treat 2016; 12:155-8. [PMID: 26834477 PMCID: PMC4716737 DOI: 10.2147/ndt.s87348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic and disabling disorder with considerable social effects and economic sequelae. It is one of the major causes of disability in young adults. OBJECTIVES This study aimed at detecting the prevalence of MS among the population of Al Quseir city. METHODS This study is a part of door-to-door survey of major neurological disorders that was conducted in Al Quseir city, Red Sea Governorate, Egypt. The sample size was 33,285 persons. The youngest patient was 17 years old. The number of people at and above 17 years of age was 21,827. They were screened by three neurologists. Then, the positive cases were subjected to meticulous clinical evaluation by three staff members of Department of Neurology, Assiut University Hospital, Egypt. Essential investigations were done. RESULTS A total of three cases of MS were diagnosed with an age-specific prevalence ≥17 years of 13.7/100,000.
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Affiliation(s)
- Hamdy N El-Tallawy
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Wafaa M A Farghaly
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Reda Badry
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Nabil A Metwally
- Department of Neurology and Psychiatry, Al Azhar University Hospital, Assiut Branch, Assiut, Egypt
| | - Ghaydaa A Shehata
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Tarek A Rageh
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Mohamed Abd El Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Mahmoud R Kandil
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
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El-Tallawy HN, Farghaly WM, Rageh TA, Shehata GA, Metwally NA, Badry R, Sayed MA, Abdelwarith AM, Kandil MR, Hamed MA, Mohamed KO, Tohamy AM. Spectrum of epilepsy - prevalence, impact, and treatment gap: an epidemiological study from Al-Quseir, Egypt. Neuropsychiatr Dis Treat 2016; 12:1111-8. [PMID: 27257380 PMCID: PMC4874633 DOI: 10.2147/ndt.s87765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Epidemiology continues to be an important research tool in the study of epilepsy and related disorders, providing a better understanding of the frequency, causes, and natural history of the disorder. OBJECTIVE To estimate the prevalence of epilepsy in Al-Quseir, Red Sea Governorate, Egypt, and its magnitude of treatment gap. METHODS The study was part of a door-to-door study, including every door, to screen all inhabitants in Al-Quseir (33,818 inhabitants) by three specialists of neurology and 15 female social workers (for demographic data collection) using a standardized screening questionnaire. All suspected cases were subjected to detailed history, clinical examination, and electroencephalogram. Neuroimaging studies and estimation of serum drug level were done in select cases if needed. RESULTS The study revealed that the lifetime prevalence rate of epilepsy in Al-Quseir is 5.5/1,000, with the highest peak during early childhood, while that of active epilepsy is 3.3/1,000 population. The annual incidence rate is 48/100,000, and the age-specific incidence rate has a U-shaped pattern with two peaks of incidence in early infancy and elderly life. Localization-related epilepsy is the most frequently encountered type (58.8%). The treatment gap of epilepsy in Al-Quseir is 83.8%. CONCLUSION The lifetime prevalence of epilepsy in Al-Quseir city, Red Sea Governorate, was 5.5/1000.
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Affiliation(s)
| | | | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | - Nabil A Metwally
- Department of Neurology, Faculty of Medicine, Al-Azhar University - Assiut Branch, Assiut, Egypt
| | - Reda Badry
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | - Ahmed M Abdelwarith
- Department of Neurology, Faculty of Medicine, Al-Azhar University - Assiut Branch, Assiut, Egypt
| | | | | | | | - Amal M Tohamy
- Department of Neurology, Assiut University, Assiut, Egypt
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Fereshtehnejad SM, Shafieesabet M, Rahmani A, Delbari A, Lökk J. Medium-to-high prevalence of screening-detected parkinsonism in the urban area of Tehran, Iran: data from a community-based door-to-door study. Neuropsychiatr Dis Treat 2015; 11:321-32. [PMID: 25709455 PMCID: PMC4327401 DOI: 10.2147/ndt.s77391] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Parkinsonism occurs in all ethnic groups worldwide; however, there are wide variations in the prevalence rates reported from different countries, even for neighboring regions. The huge socioeconomic burden of parkinsonism necessitates the need for prevalence studies in each country. So far, there is neither data registry nor prevalence information on parkinsonism in the Iranian population. The aim of our study was to estimate the prevalence rate of probable parkinsonism in a huge urban area in Iran, Tehran using a community-based door-to-door survey. MATERIALS AND METHODS We used a random multistage sampling of the households within the network of health centers consisting of 374 subunits in all 22 districts throughout the entire urban area of Tehran. Overall, 20,621 individuals answered the baseline checklist and screening questionnaire and data from 19,500 persons aged ≥30 years were entered in the final analysis. Health care professionals used a new six-item screening questionnaire for parkinsonism, which has been previously shown to have a high validity and diagnostic value in the same population. RESULTS A total of 157 cases were screened for parkinsonism using the validated six-item questionnaire. After age and sex adjustment based on the Tehran population, the prevalence of parkinsonism was calculated as 222.9 per 100,000. Using the World Health Organization's World Standard Population, the standardized prevalence rate of parkinsonism was 285 per 100,000 (95% confidence interval 240-329). The male:female ratio of probable parkinsonism was calculated as 1.62, and there was a significant increase in the screening rate by advancing age. CONCLUSION The calculated rates for the prevalence of parkinsonism in our study are closer to reports from some European and Middle Eastern countries, higher than reports from Eastern Asian and African populations, and lower than Australia. The prevalence rate of >200 in 100,000 for parkinsonism in Tehran, Iran could be considered a medium-to-high rate.
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Affiliation(s)
- Seyed-Mohammad Fereshtehnejad
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden ; Firoozgar Clinical Research Development Center (FCRDC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdiyeh Shafieesabet
- Medical Student Research Committee (MSRC), Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Rahmani
- Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Delbari
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden ; Iranian Research Center on Aging, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Johan Lökk
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden ; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
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A Review of Geoepidemiological Differences of Multiple Sclerosis in Iran and Other Middle East Countries. ARCHIVES OF NEUROSCIENCE 2014. [DOI: 10.5812/archneurosci.22028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Adeloye D. An estimate of the incidence and prevalence of stroke in Africa: a systematic review and meta-analysis. PLoS One 2014; 9:e100724. [PMID: 24967899 PMCID: PMC4072632 DOI: 10.1371/journal.pone.0100724] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/27/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Stroke is increasingly becoming a challenging public health issue in Africa, and the non-availability of data has limited research output and consequently the response to this burden. This study aimed to estimate the incidence and prevalence of stroke in Africa in 2009 towards improved policy response and management of the disease in the region. METHODS A systematic search of Medline, EMBASE and Global Health for original population-based or hospital-based studies on stroke was conducted. A random effect meta-analysis was conducted on crude stroke incidence and prevalence rates, and a meta-regression-like epidemiological model was applied on all data points. The fitted curve generated from the model was used to estimate incident cases of stroke and number of stroke survivors in Africa at midpoints of the United Nation population 5-year age groups for the year 2009. RESULTS The literature search yielded a total of 1227 studies. 19 studies from 10 African countries were selected. 483 thousand new stroke cases among people aged 15 years or more were estimated in Africa in 2009, equivalent to 81.2 (13.2-94.9)/100,000 person years. A total of 1.89 million stroke survivors among people aged 15 years or more were estimated in Africa in 2009, with a prevalence of 317.3 (314.0-748.2)/100,000 population. Comparable figures for the year 2013 based on the same rates would amount to 535 thousand (87.0-625.3) new stroke cases and 2.09 million (2.06-4.93) stroke survivors, suggesting an increase of 10.8% and 9.6% of incident stroke cases and stroke survivors respectively, attributable to population growth and ageing between 2009 and 2013. CONCLUSION The findings of this review suggest the burden of stroke in Africa is high and still increasing. There is need for more research on stroke and other vascular risk factors towards instituting appropriate policy, and effective preventive and management measures.
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Affiliation(s)
- Davies Adeloye
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Midlothian, United Kingdom
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El-Tallawy HN, Farghaly WM, Shehata GA, Badry R, Rageh TA. Epileptic and cognitive changes in children with cerebral palsy: an Egyptian study. Neuropsychiatr Dis Treat 2014; 10:971-5. [PMID: 24920910 PMCID: PMC4045262 DOI: 10.2147/ndt.s59600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is the most frequent cause of motor handicap among children. AIM OF THE STUDY We aim to study the relation of epilepsy in children with CP to various risk factors that affect the development of seizures. PATIENTS AND METHODS In a cross-sectional, descriptive, population-based, case-control study, 98 children with CP (48 children with CP with epilepsy, and 50 children with CP without epilepsy) were compared with 180 children without CP or seizures. The children lived in two regions in Egypt: the Al-Kharga District-New Valley and El-Quseir city-Red Sea. These cases were subjected to meticulous neurological assessment, brain magnetic resonance imaging, electroencephalography, and Stanford-Binet (4th edition) examination. Multinomial logistic regression was used to assess the risk factors. RESULTS Epilepsy was diagnosed in 48.9% of all cases of CP. Mental subnormality was observed more frequently in children with epilepsy than in those without epilepsy (84.6% versus 66.7%). The frequency of epilepsy was highest in patients with the spastic quadriplegic type of illness (58.3%). Multinomial logistic regression revealed that prematurity (<32 weeks of pregnancy), low birth weight (<2.5 kg at birth), neonatal seizures, jaundice, and cyanosis were significantly associated with CP with epilepsy. CONCLUSION CP is associated with a high percentage of seizure disorders. Prematurity, low birth weight, neonatal seizures, cyanosis, and jaundice are significant risk factors among patients with CP with epilepsy compared to patients with CP without epilepsy or a healthy control group.
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Affiliation(s)
| | | | | | - Reda Badry
- Department of Neurology, Assiut University Hospitals, Assiut, Egypt
| | - Tarek A Rageh
- Department of Neurology, Assiut University Hospitals, Assiut, Egypt
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